Healthcare Provider Details

I. General information

NPI: 1063341394
Provider Name (Legal Business Name): CECILIA GUERRERO
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 CURT DR STE A
CHAMPAIGN IL
61821-1168
US

IV. Provider business mailing address

1315 CURT DR STE A
CHAMPAIGN IL
61821-1168
US

V. Phone/Fax

Practice location:
  • Phone: 217-352-5179
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: